Repairing a literal hole in the heart — times two (video)

Parents of twins get double everything — double the hugs, double the giggles and double the dance performances or soccer games. They also get double the tears, double the laundry and, in the case of the Lichtenthaler family, double the concern when it comes to their daughters’ health.

Identical twins Tawna and Brielle Lichtenthaler, 22, were both born with atrial septal defect, which means that there is an abnormal connection between the left and right sides of each of their hearts. If left untreated, the American Heart Association (AHA) reports that the heart’s ability to pump may be affected, leading to heart failure. The lungs may also become gradually damaged.

“An atrial septal defect is typically a condition we are born with,” says Dr. Raghava Gollapudi, a board-certified interventional cardiologist affiliated with Sharp Memorial Hospital. “It involves a lack of tissue growth between the two chambers of the upper heart. There usually are no outward signs of a defect — as patients age, they will typically develop worsening shortness of breath or heart rhythm disorders. In severe cases, heart failure and hypoxia may develop.”

Both Brielle and Tawna reported that they would occasionally feel shortness of breath, a feeling of pressure on their chest and a quickened heartbeat during aerobic activity. But it wasn’t until Tawna received the results of a work-related physical that the defect, what she calls the “hole in her heart,” was discovered.

“It turns out, we are truly identical,” Brielle says. “We both have the same size hole.”

According to the AHA, large atrial septal defects can be closed either with open-heart surgery or during a cardiac catheterization using a device inserted into the opening to plug it. Dr. Gollapudi used a device called an Amplatzer™ Septal Occluder to repair the holes in the twins’ hearts.

The device consists of a delivery system and permanent implant. The delivery system helps transport the implant — a self-expandable double disk made from wire mesh and polyester fabric — from the groin through blood vessels to the heart. The implant is released and expanded, and remains in the heart to block the hole. Occasionally, the defect is at a hard-to-reach spot or too large to be closed via catheterization and surgery is required.

“The correction is a safe procedure that is, in general, a percutaneous approach, meaning it is done through a needle puncture or minor incision of the skin to reach the site of the repair,” says Dr. Gollapudi. “The device will straddle the hole and it takes around 30 days for the device to have tissue grow over it.”

Three months post-surgery, the twins were both back to their regular activities, even hiking Cowles Mountain, the highest peak within San Diego’s city limits. Their father, Mike Lichtenthaler, was not surprised.

“It makes me realize how strong these girls are,” he says before telling them he knows they can do anything they set their now-healthy hearts and minds to do.

For the news media: To talk with Dr. Gollapudi about atrial septal defect for an upcoming story, contact Erica Carlson, senior public relations specialist, at erica.carlson@sharp.com.